Tag: deviated septum

My New Nose

Last year, on Valentine’s Day, I had my septoplasty. I had a deviated septum, which veered to the left; my deaf side. For as long as I could remember, I had been unable to breathe through my left nostril – something I hadn’t paid much regard to until my hearing loss and the onset of the associated feeling of pressure in my ears and head.

The pressure is often the most difficult symptom to manage. It is more prominent than my tinnitus. It is ever-present, unlike my sound sensitivity for which the degree of severity is dependent on environmental sounds. With more pressure in my ears comes more dizziness. I would try almost anything to help relieve some of this discomfort as it is extremely hard to disconnect from.

Following a consultation with a particular specialist, in which he stated with confidence that the reason for the feeling of pressure in my ears was because I couldn’t breathe properly, I had elected to have the septoplasty operation. Not all specialists had given me this opinion, and so I tried not to get my hopes up regarding an improvement in my ear discomfort. The straightening of my nasal septum would enable airflow through both nostrils which, at the very least, I hoped would help me sleep better. I also had a faint hope that it could result in a reduction in the feeling of pressure in my ears and head.

The outcome of the surgery wasn’t quite what I had hoped for. The operation had been a success in that my septum was now straight. However, although I was now able to breathe air ‘out’ of the left side, I was unable to inhale. Unfortunately, the nasal valve on the left side of my nose collapsed following the surgery. This meant that every time I tried to breathe air in, the weakened side of my left nostril caved into the nasal passage; blocking the airflow. If I wore a nasal dilator strip, which I opted for during the night, I was able to breathe through both nostrils. But, as soon as the strip was removed, my nasal valve collapsed again. And so, after my septoplasty, I was still unable to breathe naturally through my left nostril and for this reason, the operation also had no impact on my associated ear symptoms.

This year I was offered another procedure to help me breathe, and of course, I agreed to it. The surgery would involve reshaping my nose to correct my breathing problem. I still refused to give up hope for having the minimum comfort of being able to breathe properly. Moreover, I retained my guarded hope for some relief from the persistent ear pressure. 

I spent the weeks leading up to my surgery exploring how my new nose would feel. To simulate my anticipated, improved breathing function I would press my left index finger on a patch of skin next to the left side of my nose and pull the skin away from my nose gently; opening up my airways. The feeling of breathing through both nostrils was wonderful and the pressure around my nose was clearly reduced. I ignored the confused and sometimes disturbed looks passers-by would give me and I’d smile with delight at the thought of this extraordinarily oxygenated state could soon be my new ‘normal’.

I had the open rhinoplasty surgery six days ago and am recovering well. The operation experience was very similar to my septoplasty. I awoke from the anaesthesia with my nostrils full of packing. There was gauze taped under my nose to catch the blood that steadily drained for the next couple of days. The first two days were predictably the most difficult. I was in a significant amount of pain, and it was very uncomfortable trying to eat or drink anything with my nose blocked with dressings. When I returned to the hospital 2 days following the surgery, the specialist removed the nasal packing and I immediately felt a lot more comfortable and had some marvellous breaths of air through both nostrils. On leaving the hospital I felt quite lightheaded from all the air I was able to breathe.

Recovery will take time and patience. My nose is full of stitches and is very sore. My face is bruised and swollen and at present, I resemble an old bruised potato. My nose is currently congested due to swelling, and I am not allowed to blow it, so it feels like I have a very bad cold. But, I am hopeful for some more wonderful full breaths of fresh air. I am hopeful for better sleep. And, I am still holding on to my most cautious of hopes; for some reduction in the constant feeling of pressure.

…I also wonder what my new nose will look like.

Stranger Things: My Septoplasty Story – Part 3

At 8am the night-shift nurses said their goodbyes to me, and new staff started to enter the room.  An hour or so later I was given some antibacterial hand gel to clean my hands and was presented with a yoghurt, a clear jelly, a pack of plain biscuits, and some thick sweet fruit juice. I devoured it all. I paid only momentary notice to the difficulty I was having in swallowing food and eating, whilst only being able to breathe through my mouth. A doctor then promptly came to give me my medical notes and said I could go home. My boyfriend arrived and a nurse changed the bandage on my nose. This time the bandage was wrapped around, leaving a small opening, showing a glimpse of the tip of my nose. My boyfriend later commented that it looked like a beak and that I should paint it yellow. Soon I was sitting up in a chair, back in the first recovery room in which I’d been the night before, just before my operation. We were given my medical notes, a Ziploc bag with painkillers and antibiotics, and an appointment for the next day for me to have the packing removed from my nostrils.

The rest of the day I spent in exhausted fogginess. I lay on the sofa and dozed intermittently; happy to be home. My boyfriend bought groceries, made soup, and washed my hair; which made me feel a little better. My nose was extremely uncomfortable. It felt like the worst congestion I could imagine; like having a terrible cold, but not being able to blow your nose. As the day turned into evening I became increasingly uncomfortable. The congestion seemed to be spreading to my throat, and breathing was becoming more of an effort. My bandage was quickly turning red. I frequently had to clear my throat of bloody mucus, which was unceasingly replenishing in supply. By the end of the evening, whenever I attempted to swallow; little pink bubbles of mucus foamed in the small opening in my beak.

That night I slept. It wasn’t a restful sleep, more of an exhausted crash. I kept waking myself up with the loudest of snores; a consequence of my mouth breathing. On waking each time I realised my discomfort, and I made numerous trips to the bathroom to spit out more mucus. Then around 5am I woke in a panic, almost unable to breathe. I went to the bathroom with the feeling of something stuck in my throat. Whilst looking at my reflection in the mirror through tired eyes, I forced the muscles in my throat to contract and relax in order to remove the obstruction. Then it slowly appeared. I gently pulled on the offender; some gooey, mucus soaked gauze. It was like something from a horror film. I was just happy that the rest of the packing from my nose didn’t follow.

The next morning I had my appointment at the hospital. I walked into the consultation room and was happy to see the initial doctor I had spoken with when I had first lost my hearing. Today she spoke to me in Spanish.  She examined my throat for gauze, and then with a thin metal hook, she removed the packing from my nose. I had an immediate sense of relief. Oh my goodness, I was so much more comfortable. The specialist asked me to try to breathe through my nose. I had a few wonderful moments of clear airways. I was breathing through both nostrils! I felt a little lightheaded. Then rapidly the airways started to clog. The doctor carried out the usual nasal examinations; inserting the thin rigid tube with the light on the end, and then using the metal pliers-type tool to lift up the end of my nose and view my nostrils. She cleaned out my nose using a spray that stung slightly, and told me that the operation had gone well.

When I arrived home that day, I realized I could smell the soup from the night before. It hadn’t even occurred to me that I couldn’t smell anything the previous day. My nose freely dripped with blood all day. I resembled the character Eleven, from the television series Stranger Things, though I was unknowing of what magic I was performing during my nosebleeds.

It has now been 9 days since my septoplasty operation. I still have numbness in my top front teeth and on a small patch of my palate. The headache, stuffiness and pain from the congestion are lessening every day. My nose is still sore, and I am still very tired. A couple of days ago I discovered stitches on the left side of my septum, which I assume will dissolve or fall out over time. Every day I have to perform nasal irrigation to clean out my nose. This entails using a specially designed plastic bottle with a thin applicator spout with a plug on the end, which fits into the nose. I fill the bottle with water and add a salt solution, and then squeeze the bottle; allowing the water to travel through one nostril and then come out through the other. My right nostril is now clear. Although I am not yet able to breathe air in through my left nostril, due to the swelling and stitches, I have been able to breathe air out of this side of my nose; which I wasn’t previously able to do. This is already a positive result.

My next appointment at the hospital is in a couple of weeks, and I am in excited anticipation for the day when I am able to breathe with ease.

 

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Waking Up: My Septoplasty Story – Part 2

I awoke from a deep satisfying sleep with my first memory being a blurry vision of my boyfriend. Well, it was rather the shape of my boyfriend in a burgundy haze; the colour of the top he was wearing. I was moving past him in my bed. Bleary-eyed, I blew him a kiss. He followed me into a recovery room. The room was brightly lit, and my eyes slowly started to focus. I excitedly told my boyfriend that I had been dreaming. I was so hungry and my throat was sore. I recollect eagerly telling the nurse that I was hungry and that although I didn’t eat meat or egg; that fish was okay. Maybe this was only a thought? My boyfriend told me later that he spent quite some time asking me whether I wanted to keep my mobile phone with me whilst staying in hospital overnight. I couldn’t make the decision. This scene is a confused dream rather than a memory to me. I saw the nurse gesturing with her arm and saying, “Adios”; requesting my boyfriend to leave. He gave me a kiss. He told me that my nose was bandaged, but that I looked okay.

Shortly, I was feeling more awake. There had been only one other patient in the room when I had arrived, and they had since been wheeled away. Now there was just me, in a space large enough for 5 more beds. There was a finger clip attached to my left index finger, which I believe measured the oxygen in my blood. Adhered to my chest in a seemingly random pattern, were circular stickers with electrodes to monitor my heart; these were attached to a machine situated behind my bed. Wrapped around my right arm was a blood pressure cuff which every hour, on the hour, inflated and took my readings. I was intravenously being administered, a steady supply of saline solution, antibiotics and painkillers. I was extremely well monitored.

There were numerous nurses that came to visit me and to check my vital signs. One of the nurses, evidently meaning well, spoke directly into my deaf ear; her lips pressed against it, with the intention of aiding my hearing. She must have been informed of my hearing loss beforehand, although evidently she hadn’t been briefed on which particular ear was affected. I didn’t have the energy or the emotional resolve to tell her that her efforts were being wasted on this ear. Later, after I guess a lack of adequate response on my part, she realised she was speaking into the wrong ear, and for the rest of the time she replicated her close-talking technique, into my hearing ear. I appreciated her committed determination to help me understand the proceedings. The dark green bed sheets were straightened by two other nurses, and within less than an hour of waking up, I was happily straining my eyes to read a magazine. I didn’t want to go back to sleep yet. I already felt like I’d had a period of concentrated rest, albeit brief. I wanted to be conscious. I didn’t like the idea of being unaware of the activity around me.

I asked the close-talking nurse if I could go to the toilet; assuming she would hook my IV bottles onto the moveable pole, so I could wheel it behind me as I walked. Unfortunately, I was mistaken. The nurse collected something from a small cupboard and then returned to my bed with the object in question. It was a bedpan made of thick paper material. She lifted up the dark green sheets and placed my paper throne in position and then walked away. Well, after a few minutes I concluded that there was no way my body was going to allow this to happen. Maybe it was a result of the anaesthetic. Maybe it was simply due to the fact that I hadn’t consumed any liquid all day. Or maybe, and most probably, it was because my body was in a state of stubborn shock. The toilet was only a few steps away from my bed – Why couldn’t I attempt to go there? I was lying down – Surely I couldn’t pee whilst lying down!? The nurse took the bedpan away after quite some time, without much comment.

That night was a restless one with mere fragments of disturbed sleep. My nose was packed with gauze-covered cotton, and there was a pad of gauze taped underneath my nostrils to soak up any blood. I also had gauze and tape wrapping around the outside of my nose. I could only breathe through my mouth. I was thirsty, yet I was only allowed a few sips of water that night before the lights were turned down. I guess this, and the introduction of the paper throne, was part of the aftercare procedure for patients following anaesthesia. I had to sleep propped up at an angle to allow the warm trickle of blood from my nose to drain into the gauze. There was a clock on the wall to the left of me, and I lay watching the movement of the hands. I slept for what seemed like half an hour, yet after observing the clock, I realized only a couple of minutes had passed. Time was behaving strangely. I guess this was a consequence of the anaesthetic or the drugs I’d been given. There was a young male nurse who checked on me every hour during the night; each time making a note of my vitals. With each check, he asked if I needed anything and if I was okay. Between his checks, I realized he was asleep in a chair around the corner from my bed. Early in the morning, he asked me if I wanted to try and pee again. I agreed. I hoped this time I would be allowed to use the facilities. But to no avail. He was soon sliding my paper throne into place. I waited and waited, urging my body to allow this unfamiliar process to happen. And then finally it did! The nurse seemed very happy with my achievement and exclaimed “Muy bien”! I had the impression that this had been a prerequisite task to be accomplished before my release. I breathed a befitting sigh of relief.

Roses are Red: My Septoplasty Story – Part 1

We were waiting in a room full of voices and echoes and were discussing how to pronounce the word for ‘surgery’ in Spanish. There was a constant movement of people in and out, and around the room. Some would walk into the room wearing orange visitor stickers. Some were carrying a single red rose wrapped in a clear sleeve. It was Valentine’s Day, and the day of my operation to correct my deviated septum; to straighten it, to allow better airflow through my nose.

I was sitting with my boyfriend in the off-white-coloured waiting room. Around the perimeter of the room were rows of chairs, with metal frames and hard wooden backs that curved slightly into the seat. In the middle of the room were two more rows of the same chairs; back-to-back. There was a dropped ceiling with suspended ceiling tiles; the Styrofoam type that are often found in offices or classrooms. Some of the tiles were discoloured or stained with the light-brown outline of irregular shapes, and were interspersed with rectangular light panels. The walls were bare apart from two Van Gogh framed prints: his Sunflowers and a painting of some wheat fields. It was difficult to judge the time of day as there was only one window, allowing a small amount of natural light to enter the room. I sat, looking around the room and watching the movement of people. There were people here of all ages. I scanned the room observing their faces. Like a detective, I assessed every person in the room. Were they wearing makeup? Jewellery? Nail polish? These were things I was told to strip my body before the operation. Were they wearing comfortable, loose-fitting clothing? I was evaluating who was here for an operation and who was simply visiting a relative or friend. There was a small door off from the waiting room to the left of where we were sitting. Some people walked straight through this door, with confidence and without the need for permission. Others had their name called by a nurse before entering. Some people came and went. Some went through the door without returning. Everyone seemed to be here for a different purpose. Every time the door opened, a sharp unsettled feeling attacked deep down in my stomach. Was it going to be a nurse calling my name? The waiting was arduous. After about 3 hours had passed we started to doubt whether we were in the right place. My boyfriend went to check; back to the original reception desk, we’d passed through before entering into the room. My appointment was for 4:30pm. It was now after 7:00pm. We were playing the game again. We were in a Spanish hospital with no idea of the procedure for having an operation here. This was new territory for us. The receptionist confirmed we were in the right place, and that they were behind schedule.

When my name was finally called it was around 8pm, and the waiting room was almost empty. I was hungry and tired, from fasting since an early breakfast. My boyfriend and I walked through the door into a corridor that opened out onto a ward. In a small changing room I dressed in a hospital gown. On my feet, I put elasticated blue foot covers that looked like delicate elf shoes. I completed my outfit by tucking my hair into a blue hair net; an action that reminded me of a short period of time spent working in factories, many years ago. We put my clothes in a locker, and retrieved the key: number 1. Then we went to wait in another room in which there were about 6 beds. I sat in a chair next to a hospital bed with dark green sheets. This seemed to be a recovery room. There were patients leaving the room after being given their hospital notes and Ziploc bags filled with medication. Some patients were in beds, with a relative beside them; waiting for them to feel well enough to return home. We waited here a while longer. I started to feel nervous.

Shortly, I was asked to get into the bed with the dark green sheets. I was wheeled through the hospital, into the lift, and then through some corridors. I was aware of my boyfriend changing position, moving from behind the bed, then to my side; endeavouring to keep up with the fast-moving trolley. The two nurses who were controlling the bed looked tired and had sour faces. At an intersection of corridors one of the nurses mumbled something hurriedly in Spanish. She was telling my boyfriend to give me a kiss and to wait “over there”. The two nurses hardly slowed the motion of the bed, and I could see my boyfriend was still processing what they had said. I told him to kiss me, and as he swiftly moved towards me, I observed his confused face in the moment of our separation.

I was on my own now. I was wheeled to a corridor where I was left without comment from the two tired nurses, for what I guess was about half an hour. I lay in the bed with my good ear facing the wall. I could hear people; I think they were behind me down the corridor. They were the voices of women speaking in quick passionate tones. They didn’t sound happy. Someone was shushing them continuously. During my wait, a few people came to talk to me and to read my medical notes. They all asked me similar questions: Where was I from? How should they pronounce my name? Do I have any allergies? All this was conducted in Spanish. I was happy to talk to people as they came to my bed. Talking was a distraction. During this time I was told that I would have to stay in hospital overnight, as it was now late, and there wouldn’t be time for me to recover from the anaesthetic. One of the members of staff asked me if I was warm enough. I told her that my feet were cold, and she folded a blanket, placing it over them. The anaesthetist also introduced himself. I think he said his name was Pablo. He was handsome and had a kind face.

Without warning my bed began to move backwards. As the bed reached a doorway, the trolley was turned around and I was facing one of the tired nurses from earlier. I was going into the operating theatre. I remember the colour green. I made an effort not to observe the room too much. The kind nurse, who earlier had asked me if I was cold, came to speak to me. She questioned me as to whether I had noticed the feeling of warmth on my feet. She had positioned a heat lamp over them, and I thanked her. The anaesthetist was situated on my deaf side, and he was kneeling down, talking to me whilst holding my hand. Simultaneously he was using his other hand to pat my arm; trying to find a vein. I smiled as he talked. I couldn’t hear him. After a moment I told him I was deaf in my left ear, and he told me he would talk louder. He said jokingly that he would try to make the sound of his voice bounce off the wall opposite, and then back to reach my good ear. The cannula was inserted with a quick sharp sting, and the anaesthetist asked me to breathe some air from a mask made of thick black rubber. I breathed in the air, and then breathed in some more…

Specialist Appointment Part 2: Ear Bubbles, a Blocked Nose… and a Plan

…The specialist only briefly addressed my noise sensitivity. It had been my understanding from my previous appointment, with the previous specialist, that the reason for me meeting with this particular Ears Nose and Throat (ENT) doctor, was to receive some sound therapy. This therapy would help retrain the auditory processing centre of my brain to accept everyday sounds. Instead of therapy, I was given a suggestion of a procedure I could perform by myself. The advice I was given during this consultation was to subject my hearing ear to noise or music, at a volume level which I found too loud, for a period of 20 minutes. I was to do this 3 times a day. I was given the example of listening to nature sounds on my headphones, whilst keeping the volume as loud as I could possibly bear it. The ENT specialist told me that eventually, I would be able to turn the volume up to higher levels. He told me that there were special hearing centres I could go to, but these would cost money, and it was customary and also effective for patients to carry out this treatment themselves. I found it curious that in the same appointment in which I had been told to avoid loud noises in order to protect my only hearing ear, I was also told to subject the same ear to noise that would cause me discomfort.

After feeling yet a little more deflated on realizing the only therapy or support this specialist was going to offer me, was the small piece of advice he’d just given me, and not a series of therapy sessions, which I had been hoping for, I started to hastily ask my friend to enquire about a few more issues; as the feeling of outstaying our allotted time started to encroach upon us.

I asked my friend, who had accompanied me to help with translation, to question the specialist about the operation I had been told about months ago, which would straighten my nasal septum, in order to help me breathe more easily. The specialist had no visible response to this enquiry, and he continued scribbling notes into my medical history booklet. With perseverance, intent on maximizing my time with the consultant, I asked my friend to mention the feeling of pressure I have in my ears, and about my bouts of dizziness, and to ask if there was anything I could do to relieve these symptoms. Without raising his head to acknowledge us, he pointed to an examination chair across the room from where we were sitting, and he mumbled something inaudible. I obediently went and sat in the chair. I had sat in this chair before. I hoped that I wasn’t going to have the customary experience of having a viewing tube inserted into my nose, for the third time. The specialist put on a head mirror and some surgical gloves, and then he reached for an examination tool. This tool appeared less sophisticated than the viewing tube. The tool resembled a pair of metal pliers; with thinner handles, and two hooked jaws. He inserted the contraption into my nose, with both of the metal hooks sliding into each nostril respectively. He swiftly and forcefully lifted the handles of the device upwards at an angle, to view inside my nose; examining the structure of my septum. He said that my nostril was completely blocked on the left side, due to the deviation of my septum. I already knew this. I have been unable to breathe through my left nostril for as long as I can remember. I had also had this same discussion, two times previously, in this same room, with two other former specialists. This information was in my medical notes, in the booklet that was sitting on the desk in this same room.

Then, without further explanation, I was asked to leave to room. I was instructed to go, for perhaps my fifth visit over the past year or so, to have a tympanometry test. A tympanometry test is often used to assess the function of the middle ear. The results of tympanometry are represented on a graph called a tympanogram. This is a graphic representation of the relationship between the air pressure in the ear canal and the movement of the eardrum, and the tiny bones in the air-filled middle ear space. When the eardrum is disturbed by a sound, part of the sound is absorbed and sent through the middle ear while the other part of the sound is reflected. The information derived from tympanometry provides information regarding middle ear function, especially Eustachian tube function.

The nurse who carried out the test was a nurse I was familiar with. She was friendly and jolly and seemed intent on carefully explaining everything to me. In the interest of respecting her, much appreciated, caring nature, I acted as though I was unfamiliar with the procedure. She kindly explained the process to me, through my friend; my translator. An ear probe was promptly placed, first into my hearing ear, and then into my deaf ear, to test the responses. As the probe in my hearing ear caused the air pressure in my ear canal to change, I heard some low-pitched tones. When my deaf ear was tested, it remained silent, with only the sound of tinnitus prevailing. While the pressure was changing, measurements of my eardrum’s movement were being taken and recorded. The test was over in a few minutes. When the nurse examined my results, she scrunched her face into a painful expression. She asked me if I have the constant feeling of being in an aeroplane. Yes! I have an unceasing pressure in my left ear, and though not as pronounced, in my right ear too. It is the feeling of pressure, comparable to being in an aeroplane and not being able to pop my ears. I also have the occasional sound of little bubbles similar to those in the foam made by bubble bath, or bubbles in fizzy drinks travelling to the surface, escaping into the air with a crackling sound. These sensations are sometimes accompanied by sharp deep and momentary pain. Yes! This pressure is causing me constant discomfort and is more difficult to manage than my actual hearing loss. Yes! This pressure I feel is what I’ve told every specialist about. Yes! This wonderful nurse had immediately identified this as a significant source of discomfort and was showing empathy towards my situation. She was the first person in over a year of consultations, to not just read my results and identify a problem, but to actually show some understanding of the unpleasantness I was experiencing.

I returned to the consultation room and showed the doctor my tympanogram. After regarding it for a moment, he told me with confidence that the reason I have the feeling of pressure in my ears is because I can’t breathe properly. This is not what I’d been told before. I had been told that there could possibly be a link between my inability to breathe effectively through my left nostril, and my ear pressure. I had believed that the pressure was a consequence of my hearing loss. The onset of the feeling of pressure had, after all, coincided exactly with the moment I lost my hearing. I told him that it had not been communicated previously to me that the issues with my nose were the certain cause of the discomfort in my ears. He repeated with a vehement assurance that the pressure in my ears was a direct result of my difficulty breathing. This was something new to me.

The specialist then questioned me about my sleeping habits. I told him how I have struggled to sleep, to the best of my recollection, for most of my adult life. I told him how I find it difficult to fall asleep, due to problems breathing. I told him how my brain seems to wake me up just as the rest of my body feels like it’s going to sleep. I told him that I am only able to sleep effectively whilst lying on my left side. If I sleep on my right side; the side of my functioning airway, the nostril closes up which means I can’t breathe at all through my nose. He told me that I needed the septoplasty. This operation would straighten my septum, allowing for better airflow through my nose.

There are long term effects of a deviated septum. In my case, having a deviated septum has meant that not only have I had many sinus infections, but I also often get throat infections; as I regularly breathe through my mouth. The blocked nasal breathing due to septal deviation also has a negative effect on the Eustachian tube, which means drainage from the nose is not efficient. If what the specialist was saying was correct, having the operation could lead to better tubal drainage from my nose, and as a result, this could relieve some of the pressure I am feeling in my ears.

My hope for this operation is that it will help me feel more comfortable whilst sleeping at night, as I will be able to breathe through both nostrils. After some time I should start breathing through my nose more during the night, and therefore shouldn’t wake up as much; as a result of having a dry mouth, or as a response to my body warning me that I am not managing to get enough oxygen into my lungs. In consequence, I hope I will also feel more refreshed when I wake up. My most cautious hope, however, is for an eventual reduction in the pressure I am feeling in my ears.

And so, after over a year of rapid changes of emotion, I am once again feeling hopeful…